Employee Status and Information Changes

Processing a variety of status and information changes on behalf of your employees is easy with Blue Shield’s online enrollment tools.

Employee information changes

Member information that has changed or requires correction can be submitted through the Employer Enrollment Tool or on your group’s Electronic Data Interchange (EDI). Updatable information includes:

• First, middle, and last name
• Date of birth
• Marital status, gender, and gender identification
• Employee date of hire
• Address, phone number, and email address
• Employee subgroup, class, and department code
   

Leave of absence

When an employee takes a leave of absence consistent with your company's personnel policy, no special action is needed regarding Blue Shield coverage.

If your company requires employees to pay for their group health plan coverage during a leave period, then payment must be made payable to your company and not to Blue Shield. Your monthly billing statement will include the name of the employee on leave.

If an employee is on approved family leave and your company is subject to the federal Family and Medical Leave Act of 1993, payment of the employee’s dues will maintain coverage for any allowable time periods.

The length of an employee leave of absence or any subsequent termination is determined by your company's personnel policy.

You must notify Blue Shield when you terminate the employee by calling the Group Eligibility Customer Service at (800) 325-5166. An employee who is on leave and is terminated may qualify for continuation coverage similar to a terminated employee who is actively working on his or her last day of coverage.
 

Covered child dependents when divorce, legal separation, or termination of domestic partnership occurs

When an employee becomes divorced or legally separated, dependent children do not lose eligibility for coverage and may continue to be covered as the employee’s dependents. If the employee decides to cancel the children's group coverage, he or she may elect COBRA or Cal-COBRA Continuation for them within the 60-day election period.

When an employee has a termination of domestic partnership, dependent children will end coverage at the end of the month in which the domestic partnership or divorce occurs. Federal COBRA coverage is not available but Cal-COBRA may be available.

Covered spouse when divorce, legal separation, or termination of domestic partnership occurs

Former spouses and domestic partners lose coverage under the employee’s group benefits plan.

Former spouses may be eligible for both federal COBRA or Cal-COBRA, while former domestic partners are not eligible for federal COBRA but may be eligible for Cal-COBRA.

Need help?

Consult your Administrator's Guide for more information.